Aa
As relates to recent "HCV & Brain Infection" study, and threads!
Here is a copy of my thread from a few years back, speculating on the other organs and tissues that might become infected by HCV, and may or may not be cleared by successful tx. We still do not know what happens to those who have the "HCV Brain Infection" recently demonstrated by researchers (see recent threads) either during their infection, or after clearing HCV from the blood with tx. I think some of my comments and conjectures may well be pertinent to the recent study, and ultimately will require investigation to determine what happens, and when...as well as which tissues and organs actually become infected, excluding the blood supply around these cells and structures. Anyway, here is my old thread. It might be thought provoking today, moreso than when it was posted.
Lost Post: Persistent HCV and Occult Issues; Mike, TnHep, Willing, Tater, etc.
by DoubleDose, Jul 13, 2007 08:41AM
Tags: persistent, occult, Hepatitis, Hepatitis C, brain, liver
Here is a post that was lost during the transition to the new format:
I just returned to town yesterday only to read the recent threads regarding occult HCV and HBV issues. Thanks for bringing the 'old board' back to life!!! Good to hear all of you weighing in, and contributing material for the forum.
Now, as you all know, I have pretty adament opinions on HCV occult, and persistent viral behaviors. Of course my more radical suppositions are still very un-researched, and generally met with skepticism.....BUT each new research article on Persistence after SVR, and after spontaneous clearance, only lends more strength to my concerns.
I begin to see a potential cause for all the Post-SVR problems, that may go beyond Interferon hangover, and damage from tx. I think that the odd, infectious state that may exist after SVR, might well be responsible for many of our long term woes. I still believe that the virus does much more within our bodies than currently understood by mainstream HCV experts. I suspect that Central Nervous System issues, and infection are probably a reality, as well as the Lymphoid, connective tissue, and possibly Brain cell structures as well.
Whether lingering, low level virus causes actual damage in these organs, or causes an 'auto-immune' response is open to question...but I really believe there is something going on....in the SVR population. Maybe the 'liver/ blood' virus, is really a multi-faceted, multi-system infection, that only becomes highly visible, and detectable, when it overcomes the immune barriers, and becomes a chronic, and/or acute blood infection. Thus IVDU's are the most 'visible' group, and generally have the full bore infection!
I still strongly suspect other modes of infection, and transmission, that are NOT the typical, detectable 'Blood/ Liver' types of infection. If the virus can live, and reproduce in Lymphatic, Salivary, connective, and nerve tissue, then there is no reason it cannot be transmitted directly from these to similar tissues in others. It may just not become, nor provoke, a 'typical HCV blood infection', in those persons. Possibly sexual tissues, and gastric tissues could also become infected, and set up silent, undetected low level states of reproduction, causing vague digestive, and reproductive problems. All undetected by typical HCV testing.
I know this is somewhat of a stretch from the straight information the research studies have provided, but there is a LOGIC to what I am stating. And it all follows the findings of the research lately.
I would love to hear some discussion on these theories. I will accept the criticism as well, in advance! Just my individual take on what might be going on. I still can swear that I see odd symptoms in intimate contacts from over the years. Much like CFS, or CFIDS. All these contacts are 'undetected' for the typical blood HCV antibodies. But now, I have more ammunition for why this might be so. Maybe the infection is cellular, and localized. Maybe it is held 'in-check' like SVR's. It might cause NO antibody reaction whatsoever in the blood, but might cause lots of symptoms. (and provoke lots of immune system reactions)
Best wishes to all, and hopes that you are all well, and enjoying the holiday! Let's hear the hooting!
DoubleDose
Lost Post: Persistent HCV and Occult Issues; Mike, TnHep, Willing, Tater, etc.
by DoubleDose, Jul 13, 2007 08:41AM
Tags: persistent, occult, Hepatitis, Hepatitis C, brain, liver
Here is a post that was lost during the transition to the new format:
I just returned to town yesterday only to read the recent threads regarding occult HCV and HBV issues. Thanks for bringing the 'old board' back to life!!! Good to hear all of you weighing in, and contributing material for the forum.
Now, as you all know, I have pretty adament opinions on HCV occult, and persistent viral behaviors. Of course my more radical suppositions are still very un-researched, and generally met with skepticism.....BUT each new research article on Persistence after SVR, and after spontaneous clearance, only lends more strength to my concerns.
I begin to see a potential cause for all the Post-SVR problems, that may go beyond Interferon hangover, and damage from tx. I think that the odd, infectious state that may exist after SVR, might well be responsible for many of our long term woes. I still believe that the virus does much more within our bodies than currently understood by mainstream HCV experts. I suspect that Central Nervous System issues, and infection are probably a reality, as well as the Lymphoid, connective tissue, and possibly Brain cell structures as well.
Whether lingering, low level virus causes actual damage in these organs, or causes an 'auto-immune' response is open to question...but I really believe there is something going on....in the SVR population. Maybe the 'liver/ blood' virus, is really a multi-faceted, multi-system infection, that only becomes highly visible, and detectable, when it overcomes the immune barriers, and becomes a chronic, and/or acute blood infection. Thus IVDU's are the most 'visible' group, and generally have the full bore infection!
I still strongly suspect other modes of infection, and transmission, that are NOT the typical, detectable 'Blood/ Liver' types of infection. If the virus can live, and reproduce in Lymphatic, Salivary, connective, and nerve tissue, then there is no reason it cannot be transmitted directly from these to similar tissues in others. It may just not become, nor provoke, a 'typical HCV blood infection', in those persons. Possibly sexual tissues, and gastric tissues could also become infected, and set up silent, undetected low level states of reproduction, causing vague digestive, and reproductive problems. All undetected by typical HCV testing.
I know this is somewhat of a stretch from the straight information the research studies have provided, but there is a LOGIC to what I am stating. And it all follows the findings of the research lately.
I would love to hear some discussion on these theories. I will accept the criticism as well, in advance! Just my individual take on what might be going on. I still can swear that I see odd symptoms in intimate contacts from over the years. Much like CFS, or CFIDS. All these contacts are 'undetected' for the typical blood HCV antibodies. But now, I have more ammunition for why this might be so. Maybe the infection is cellular, and localized. Maybe it is held 'in-check' like SVR's. It might cause NO antibody reaction whatsoever in the blood, but might cause lots of symptoms. (and provoke lots of immune system reactions)
Best wishes to all, and hopes that you are all well, and enjoying the holiday! Let's hear the hooting!
DoubleDose
Hi I agree with your post. I had many "symptoms" diabetes, gall stones, salivary gland tumor, fatigue, concentration problems before finally being diagnosed with HCV in late 2007
I was tested in the mid 90's (3X) and came back neg every time even though my liver enzymes were elevated. In 2007, when finally tested positive my liver enzymes had been slightly elevated since the late 80's so something was going on, they just didn't have a test for it yet. Once I had the biopsy the doc said that my blood work did not indicate how sick I was, 2/4 test result so I could not wait for tx but had to tx right away.
Thanks for the post, very "THOUGHT PROVOKING"
I was tested in the mid 90's (3X) and came back neg every time even though my liver enzymes were elevated. In 2007, when finally tested positive my liver enzymes had been slightly elevated since the late 80's so something was going on, they just didn't have a test for it yet. Once I had the biopsy the doc said that my blood work did not indicate how sick I was, 2/4 test result so I could not wait for tx but had to tx right away.
Thanks for the post, very "THOUGHT PROVOKING"
I am one of those that had major joint pains and body aches among other things diagnosed with fibro after TX and clearing HCV. The diagnosis came after a whole bunch of tests, not just a doctors opinion.
Something started happening about a year and a half before diagnosis as I had the "flu" or the symptoms of such more often (like every month or so) than I ever had in my life.
Denise
Something started happening about a year and a half before diagnosis as I had the "flu" or the symptoms of such more often (like every month or so) than I ever had in my life.
Denise
"Also if HCV is so damaging to the body why do the vast majority of people infected for decades have no noticeable symptoms? Which is why most people don't even know they are infected.
Also if it HCV is damaging all these organ, tissue and systems. Why is there no medical evidence of this? Blood levels remain normal for many decades (until the liver develops advanced fibrosis) and there is no physical damage to any of these body parts you mention? "
Hector, my own theory on that is that there HAS been damage and the connection to HCV hasn't been recognized. Over time, it's becoming more increasingly known that illnesses like Diabetes and Fibromyalgia have increased occurrences among those with HCV. I think over time that onset of Diabetes, and perhaps other illnesses as more becomes known, will also include a test for HCV to rule that out as a mitigating factor.
Also if it HCV is damaging all these organ, tissue and systems. Why is there no medical evidence of this? Blood levels remain normal for many decades (until the liver develops advanced fibrosis) and there is no physical damage to any of these body parts you mention? "
Hector, my own theory on that is that there HAS been damage and the connection to HCV hasn't been recognized. Over time, it's becoming more increasingly known that illnesses like Diabetes and Fibromyalgia have increased occurrences among those with HCV. I think over time that onset of Diabetes, and perhaps other illnesses as more becomes known, will also include a test for HCV to rule that out as a mitigating factor.
Sporadic Reappearance of Minute Amounts of HCV RNA after Successful Therapy Stimulates Cellular Immune Responses.
Veerapu NS, Raghuraman S, Liang TJ, Heller T, Rehermann B.
Immunology Section, NIDDK, National Institutes of Health, DHHS, Bethesda, MD 20892, USA; Liver Diseases Branch, NIDDK, National Institutes of Health, DHHS, Bethesda, MD 20892, USA.
Abstract
BACKGROUND & AIMS: Several studies have reported persistence of hepatitis C virus (HCV) RNA in the circulation after treatment-induced or spontaneous recovery. We investigated whether the HCV RNA represents persistence of HCV infection or re-infection.
METHODS: We studied 117 patients that recovered from HCV infection (98 following therapy and 19 spontaneously). A reverse transcriptase (RT)-PCR assay was used to detect the 5'UTR of HCV RNA. T-cell responses were studied by ELISpot analysis of interferon-γ.
RESULTS: Plasma samples from 15% of patients who recovered following treatment and none who recovered spontaneously tested positive for HCV RNA. Lymphocytes from 3 patients that responded to therapy and 1 that recovered spontaneously tested positive. The frequency of HCV RNA detection in plasma correlated inversely with the time after the end of treatment. Post-treatment HCV 5'-UTR sequences matched pre-treatment sequences in 85% of cases. T-cell responses were significantly greater at timepoints with detectable trace amounts of HCV RNA than at timepoints without detectable HCV RNA (P=0.035) and were primarily against nonstructural HCV antigens. The immune hierarchy was preserved over 5 years in patients; post-treatment HCV RNA sequences matched pretreatment sequences, indicating HCV RNA persistence. An altered immune hierarchy with dominant immune responses, shifting from nonstructural to structural antigens, was observed in a single patient. The genotype of the detected post-treatment HCV RNA differed from that of the pretreatment genotype in this patient, indicating re-infection with HCV.
CONCLUSIONS: Trace amounts of HCV RNA of pretreatment sequence persisted and re-appeared sporadically in the circulation within 8 years after recovery from hepatitis C but not thereafter, indicating that patients are cured of HCV infection. Reappearance of HCV RNA induced HCV-specific T-cell responses. All studies published in Gastroenterology are embargoed until 3PM ET of the day they are published as corrected proofs on-line. Studies cannot be publicized as accepted manuscripts or uncorrected proofs.
http://www.ncbi.nlm.nih.gov/pubmed/21040725
Mike
Veerapu NS, Raghuraman S, Liang TJ, Heller T, Rehermann B.
Immunology Section, NIDDK, National Institutes of Health, DHHS, Bethesda, MD 20892, USA; Liver Diseases Branch, NIDDK, National Institutes of Health, DHHS, Bethesda, MD 20892, USA.
Abstract
BACKGROUND & AIMS: Several studies have reported persistence of hepatitis C virus (HCV) RNA in the circulation after treatment-induced or spontaneous recovery. We investigated whether the HCV RNA represents persistence of HCV infection or re-infection.
METHODS: We studied 117 patients that recovered from HCV infection (98 following therapy and 19 spontaneously). A reverse transcriptase (RT)-PCR assay was used to detect the 5'UTR of HCV RNA. T-cell responses were studied by ELISpot analysis of interferon-γ.
RESULTS: Plasma samples from 15% of patients who recovered following treatment and none who recovered spontaneously tested positive for HCV RNA. Lymphocytes from 3 patients that responded to therapy and 1 that recovered spontaneously tested positive. The frequency of HCV RNA detection in plasma correlated inversely with the time after the end of treatment. Post-treatment HCV 5'-UTR sequences matched pre-treatment sequences in 85% of cases. T-cell responses were significantly greater at timepoints with detectable trace amounts of HCV RNA than at timepoints without detectable HCV RNA (P=0.035) and were primarily against nonstructural HCV antigens. The immune hierarchy was preserved over 5 years in patients; post-treatment HCV RNA sequences matched pretreatment sequences, indicating HCV RNA persistence. An altered immune hierarchy with dominant immune responses, shifting from nonstructural to structural antigens, was observed in a single patient. The genotype of the detected post-treatment HCV RNA differed from that of the pretreatment genotype in this patient, indicating re-infection with HCV.
CONCLUSIONS: Trace amounts of HCV RNA of pretreatment sequence persisted and re-appeared sporadically in the circulation within 8 years after recovery from hepatitis C but not thereafter, indicating that patients are cured of HCV infection. Reappearance of HCV RNA induced HCV-specific T-cell responses. All studies published in Gastroenterology are embargoed until 3PM ET of the day they are published as corrected proofs on-line. Studies cannot be publicized as accepted manuscripts or uncorrected proofs.
http://www.ncbi.nlm.nih.gov/pubmed/21040725
Mike
DD it's awlays good to see you here again - even if I have no answers to any of your intellectual thought provokiing stuff, it's always good to read and contemplate.
I don't know either way about occult virus (I like to believe no but again have read so much that i can't tell either way); however, I do admit I dont think my memory/brain function is near to what it was pre-treatment. But given the option - I'd have to go with treatment every time.
I would love to have something to blame it on aside from tx meds though - it would make people feel way better about doing treatment in the first place.
Again, great to see you old timer - you should pop in more often to say hello to your old friends.
deb
I don't know either way about occult virus (I like to believe no but again have read so much that i can't tell either way); however, I do admit I dont think my memory/brain function is near to what it was pre-treatment. But given the option - I'd have to go with treatment every time.
I would love to have something to blame it on aside from tx meds though - it would make people feel way better about doing treatment in the first place.
Again, great to see you old timer - you should pop in more often to say hello to your old friends.
deb
sorry for my rude reaction. post tx concerns are not yet on my radar so i was being narrow minded. no excuse, babs
I personally find this subject very interesting. Especially since I am still suffering from some post tx memory and cognitive problems. It might not be relevant for a lot of people, but it is relevant to my personal situation. For me it started a few months before starting treatment, went really bad during treatment andI have had problems since.
I've had a full check-up with CT-scans and everything and they couldn't find anything. One thing they told me though, was that they do not have the technology at this moment to check further into the brain to be able to detect these things. They have a lot of people coming with the same complaints I have, but cannot help them. Maybe in 10 years, 20 years, who knows. That's what they said to me here at the main hospital in Copenhagen.
My question would be, since the virus passes the blood brain barrier, does HCV SOC treatment also pass the blood brain barrier?
Let's say it does. What happens next? Does treatment then kill off the infected cells while eradicating the virus? And is that why these cognitive/memory problems arise in some of us?
Could it be that people who do have these problems after tx are people who had a larger quantity of infected brain cells than people who don't have this problem?
Is there a difference of 'brain problems' after tx between people who SVRed and people who didn't?
I don't think they have the answers to any of this yet, but as medicine evolves and more research is done on the virus, they might come up with more surprising facts.
Maybe if they find out why and how, they will also be able to help people with the 'brain problems'.
I really wouldn't mind getting my pre tx brain back. And I'm sure I'm not the only one.
I've had a full check-up with CT-scans and everything and they couldn't find anything. One thing they told me though, was that they do not have the technology at this moment to check further into the brain to be able to detect these things. They have a lot of people coming with the same complaints I have, but cannot help them. Maybe in 10 years, 20 years, who knows. That's what they said to me here at the main hospital in Copenhagen.
My question would be, since the virus passes the blood brain barrier, does HCV SOC treatment also pass the blood brain barrier?
Let's say it does. What happens next? Does treatment then kill off the infected cells while eradicating the virus? And is that why these cognitive/memory problems arise in some of us?
Could it be that people who do have these problems after tx are people who had a larger quantity of infected brain cells than people who don't have this problem?
Is there a difference of 'brain problems' after tx between people who SVRed and people who didn't?
I don't think they have the answers to any of this yet, but as medicine evolves and more research is done on the virus, they might come up with more surprising facts.
Maybe if they find out why and how, they will also be able to help people with the 'brain problems'.
I really wouldn't mind getting my pre tx brain back. And I'm sure I'm not the only one.
Looking at past threads this subject has been discussed to the point that the same arguments are repeated over and over and no new light has been generated only heat.
* One study does not make its conclusions a fact.
* As for extrahepatic symptoms that has always been known. Nothing new there. For us decompensated cirrhosis patients you don't need to tell us about extrahepatic symptoms. Many of them are fatal. What does that have to do with the virus being eradicated or not?
If you feel like you have brain issues caused by having HCV I am sorry you are experiencing that. But to ignore basic facts about the disease and putting blinders on because you want to believe your "brain issues" are related to HCV is not convincing.
There are other physical and mental health diseases besides HCV.
hectorsf
* One study does not make its conclusions a fact.
* As for extrahepatic symptoms that has always been known. Nothing new there. For us decompensated cirrhosis patients you don't need to tell us about extrahepatic symptoms. Many of them are fatal. What does that have to do with the virus being eradicated or not?
If you feel like you have brain issues caused by having HCV I am sorry you are experiencing that. But to ignore basic facts about the disease and putting blinders on because you want to believe your "brain issues" are related to HCV is not convincing.
There are other physical and mental health diseases besides HCV.
hectorsf
And please don't take my comments as being a wiseacre...I was not trying to be flippant...but just posted the old thread to remind some of the older Forum members that my 'far fetched' ideas may not have been so far out at all....The Brain Infection findings are very much in line with what I had posited. I don't like the idea any more than anyone on this forum...but I really would like to find out once and for all what has caused so much cognitive deterioration over the years...memory lapses, fatigue, depression...etc....and if its a brain cell infection...then let's by golly make sure that the tx did the trick entirely...and if not...then let the researchers and pharmas come up with better, more comprehensive cures!! That's my only point, and goal. And thanks for the light-hearted reply! Its appreciated.
DD
DD
Please refer to the recent study posted which demonstrates that HCV can, and often does, infect Brain Tissues....they do not know whether that infection clears when you SVR...and all is not always cut and dried as you indicated. There are plenty of other types of cell structures other than blood and liver that can and often are affected by HCV. We HOPE that all of the cellular infection is gone after SVR...but the recent brain studies, posted in the past week or two, on the forum, may potentially throw a monkey wrench in that concept. And also, many people with HCV have severe extrahepatic symptoms, with little or no damage to the liver. Now, what do you suppose causes those symptoms? The Canadian researchers think they may know now...the brain infection may be the culprit. Always keep an open mind.
DD
DD
"HCV may or may not be cleared by successful tx".
The bottom line is when a patient achieves SVR, HCV is eliminated throughout the entire body.
* SVR is a measurement of the blood which flows through all organs and tissues.
* A SVR patient does not get reinfected and start replicating the virus again except by a new event of being exposed to the virus from outside of the body.
* If the patient achieves SVR before a transplant the virus does not reappear in the patient's new liver.
Viruses have one task. That is to replicate. If they don't replicate they die in a short time. The HCV targets the liver cells where it replicates, is released from the infected cell and goes on to infect more healthy cells.
Also if HCV is so damaging to the body why do the vast majority of people infected for decades have no noticeable symptoms? Which is why most people don't even know they are infected.
Also if it HCV is damaging all these organ, tissue and systems. Why is there no medical evidence of this? Blood levels remain normal for many decades (until the liver develops advanced fibrosis) and there is no physical damage to any of these body parts you mention?
So I guess I don't understand what your point is.
hectorsf
The bottom line is when a patient achieves SVR, HCV is eliminated throughout the entire body.
* SVR is a measurement of the blood which flows through all organs and tissues.
* A SVR patient does not get reinfected and start replicating the virus again except by a new event of being exposed to the virus from outside of the body.
* If the patient achieves SVR before a transplant the virus does not reappear in the patient's new liver.
Viruses have one task. That is to replicate. If they don't replicate they die in a short time. The HCV targets the liver cells where it replicates, is released from the infected cell and goes on to infect more healthy cells.
Also if HCV is so damaging to the body why do the vast majority of people infected for decades have no noticeable symptoms? Which is why most people don't even know they are infected.
Also if it HCV is damaging all these organ, tissue and systems. Why is there no medical evidence of this? Blood levels remain normal for many decades (until the liver develops advanced fibrosis) and there is no physical damage to any of these body parts you mention?
So I guess I don't understand what your point is.
hectorsf
DD, you know I don't stick my head in the sand. More times than not, I'm the big old flapping gooney bird running around the board.
Getting over a major hurdle as in curing ourselves of HCV (relatively speaking) would probably be enough for me but I do understand inquiring minds want to know.
Trin
Getting over a major hurdle as in curing ourselves of HCV (relatively speaking) would probably be enough for me but I do understand inquiring minds want to know.
Trin
I understand your sentiment, and I can agree, to a point....but whether we don't want to 'dwell on it' or not, if our brains are still infected (and the research has not provided that answer yet) I think we may want to see further advances in treatment, and be able to ultimately determine whether we suffer from this particular infection, or not. Some of us may really feel more comfortable 'sticking our heads in the sand', but then again, I think that some of us would rather know the answers, and see science address any remaining problems. I think that personally, I am a believer in 'knowing'....oh well....what can I say?
DD
DD
Not everyone has post SVR problems and even if I was SVR and did have some problems I don't think I'd want to dwell on it. My thoughts are.... seriously, I don't care about residual HCV. Would just like to get rid of what I've got without being provoked....
I mean my thoughts. :)
Trin
I mean my thoughts. :)
Trin
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